There are several reasons physician payment reform legislation is moving forward now. One widely cited reason is the much lower budgetary cost of a permanent fix: since last year, the 10-year cost of replacing the current SGR declined by more than half, from $297 billion to $117 billion for a 0% update and to $136 billion for a 0.5% update.
The other, perhaps less appreciated reason is that support among physician groups is growing for alternatives to both the short-term SGR patches and RBRVS. Many primary care and specialty groups have been developing and in some cases implementing the kinds of payment reforms described above, in some cases in Medicare pilot projects and frequently in private insurance plans and state Medicaid programs. As a result, these alternatives are gaining traction as a potential way out of the endless payment rate cuts and physician frustrations with the lack of support in fee-for-service payments for steps they would like to take to improve care and lower costs.
I’ve always believed the former, but not necessarily the latter. I’d love to be wrong about that. In addition, Congress still has to find a way to pay for the ~$150 billion price tag for the fix.
Time will tell…